Publications by authors named "Kara Fitzgibbon"

2 Publications

  • Page 1 of 1

Nephrology and Palliative Care Collaboration in the Care of Patients With Advanced Kidney Disease: Results of a Clinician Survey.

Kidney Med 2021 May-Jun;3(3):368-377.e1. Epub 2021 Mar 31.

Palliative Care Services, University of Virginia Health, University of Virginia School of Medicine, Charlottesville, VA.

Rationale & Objective: Despite calls for integrating palliative care into chronic kidney disease (CKD) care, uptake remains low. The study aim was to describe clinicians' perceptions of the clinical and research priorities in CKD care and the main barriers to collaboration.

Study Design: This was a descriptive cross-sectional study using an online survey developed by clinicians and researchers as the primary data collection method.

Setting & Participants: Clinicians in nephrology and palliative care departments (N = 195) at an academic health center in Virginia were invited to participate. Of the 48.7% (n = 95) who responded, most were registered nurses (65.3%) in nephrology (80%) with more than 15 years' experience (40%).

Predictors: Factors including discipline (nursing, social work, and physician) and practice area (palliative care or nephrology) were assessed.

Outcomes: Main outcomes of interest included clinicians' perceptions of the role of palliative care, barriers to collaboration, and the top clinical and research priorities for patients with advanced CKD.

Analytic Approach: Survey data were analyzed using SPSS using descriptive statistics.

Results: Respondents reported being comfortable caring for patients near the end of life and endorsed advance care planning and collaboration between nephrology and palliative care teams. However, both rarely happen. Fragmentation, or poor coordination of care, was perceived to be the main barrier to collaboration. Perceptions regarding collaboration facilitation differed; nephrology clinicians identified patient/family education as the most important facilitator while palliative care clinicians identified clinician education as most important. Top clinical priorities differed. Palliative care clinicians reported pain/symptom management as taking priority while nephrology clinicians identified caregiver/family support. Developing interventions to support treatment-related decision making was the top research priority.

Limitations: Results reflect perceptions of about half the clinicians at 1 academic health center.

Conclusions: Additional studies to capture patients' and families' perspectives and examine end-of-life care processes are needed. Results may inform future targeted interventions.
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March 2021

From loquacious to reticent: understanding patient health information communication to guide consumer health IT design.

J Am Med Inform Assoc 2017 Jul;24(4):680-696

Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.

Background And Significance: It is increasingly recognized that some patients self-manage in the context of social networks rather than alone. Consumer health information technology (IT) designed to support socially embedded self-management must be responsive to patients' everyday communication practices. There is an opportunity to improve consumer health IT design by explicating how patients currently leverage social media to support health information communication.

Objective: The objective of this study was to determine types of health information communication patterns that typify Facebook users with chronic health conditions to guide consumer health IT design.

Materials And Methods: Seven hundred participants with type 2 diabetes were recruited through a commercial survey access panel. Cluster analysis was used to identify distinct approaches to health information communication both on and off Facebook. Analysis of variance (ANOVA) methods were used to identify demographic and behavioral differences among profiles. Secondary analysis of qualitative interviews ( n  = 25) and analysis of open-ended survey questions were conducted to understand participant rationales for each profile.

Results: Our analysis yielded 7 distinct health information communication profiles. Five of 7 profiles had consistent patterns both on and off Facebook, while the remaining 2 demonstrated distinct practices, with no health information communication on Facebook but some off Facebook. One profile was distinct from all others in both health information communication practices and demographic composition. Rationales for following specific health information communication practices were categorized under 6 themes: altruism, instrumental support, social support, privacy and stigma, convenience, and Facebook knowledge.

Conclusion: Facebook has been widely adopted for health information communication; This study demonstrates that Facebook has been widely adopted for health information communication. It also shows that the ways in which patients communicate health information on and off Facebook are diverse.
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July 2017